Various Pathologic Lesions Associated with Anterior Shoulder Instability: Experience over 10-Years of Arthroscopic Treatment

Rhee, Kwang Jin; Byun, Ki Yong; Lee, Suk Joon; Chung, Sang Yun; Kim, Dong Hee

Abstract

PURPOSE: We report upon the frequency and results of treatment for various pathologic lesions such as ALPSA lesions, capsular laxity, mid-capsular tear and HAGHL lesions in cases of anterior shoulder instability.
MATERIALS AND METHODS
Two hundred and four consecutive patients with anterior shoulder instability underwent arthroscopic repair and the outcomes were evaluated according to various lesions and treatment modalities in a retrospective study afte a minimum of one year elapsed after surgery. RESULT: All 24 cases of ALPSA lesions were treated using the arthroscopic transglenoid suture technique. Clinical results were excellent in 18 cases. Of 67 cases of capsular laxity, type IV Bankart lesion was combined in 42. 47 cases were treated with the transglenoid technique and 20 with the transglenoid suture technique and capsular shrinkage. The clinical results were excellent in 45 cases. All 11 cases of mid-capsular tear were treated with its combined lesion, and the clinical results proved to be excellent in 8 cases. Of the 4 cases of HAGHL lesions, all cases were treated with the direct suture technique, and 2 had excellent clinical results.
CONCLUSION
In the case of anterior shoulder instability, various pathologic lesions as well as Bankart lesion can be found. Therefore, the evaluation of the exact pathologic lesion causing instability and its appropriate treatment are important for satisfactory surgical outcomes. The arthroscopic transglenoid suture technique is one of the most useful methods of reconstruction in various pathologies of shoulder instability.